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C A L I F O R N I A S T A T E P O L Y T E C H N I C U N I V E R S I T Y, P O M O N A
Disability Resource Center
Guidelines for Documenting Attention Deficit/Hyperactivity Disorder (AD/HD)1
The following guidelines describe the necessary components of acceptable documentation for students requesting
academic accommodation(s) due to disability arising from Attention Deficit/Hyperactivity Disorder (AD/HD). Our
office may approve some, all, or none of the requested accommodations depending on the sufficiency of the
documentation provided. If the documentation is deemed insufficient, Disability Resource Center (DRC) will provide
the student with an opportunity to address limitations in the documentation. DRC will make the final determination
regarding what accommodations are reasonable or appropriate to the learning environment at Cal Poly Pomona.
Definitions
The current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders
should be utilized in determining if an individual meets the criteria for a diagnosis of ADHD. ADHD is defined as “a
persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as
characterized by…symptoms that have persisted for at least 6 months to a degree that is inconsistent with
developmental level and that negatively impacts directly on social and academic/occupational difficulties” (DSM-5,
2013, p. 59).
The Americans with Disabilities Act, as amended (ADAAA) and Section 504 of the Rehabilitation Act define a disability
as a physical or mental condition that substantially limits a major life activity. Persons with ADHD, in particular, may
experience difficulties with remembering, learning, reading, concentrating and/or thinking, socially interacting and/or
communicating, which may interfere directly with their ability to function in a university setting.
Accommodations refer here to any modification or adjustment to academic policies or standard practices for the
purpose of allowing an individual with a disability equal access to the postsecondary academic environment without
fundamentally altering essential curriculum or course requirements.
A Qualified Professional Must Conduct the Evaluation
Qualified professionals are licensed individuals who are have experience and training in evaluating and diagnosing
ADHD, differential diagnosis of mental health disorders, has worked with postsecondary disability service providers or
campus offices for college students with disabilities, and can provide a comprehensive evaluation written report.
Clinicians typically qualified to provide a comprehensive diagnostic evaluation and testing for ADHD are licensed
clinical psychologists and neuropsychologists. Although psychiatrists are typically qualified to diagnose ADHD, they
often do not provide the type of comprehensive evaluation and/or documentation required. It may be appropriate to
use a clinical team approach consisting of a variety of educational, medical, and counseling professionals with training
in the evaluation of ADHD in adolescents and adults.
The name, title and professional credentials of the evaluator — including information about licensure or certification,
employment, and state in which the individual practices — should be clearly stated in the documentation. All reports
1
Guidelines adapted from Office of Disability Policy, Educational Testing Service (2008). Policy Statement for Documentation of
Attention-Deficit/Hyperactivity Disorder (ADHD) in Adolescents and Adults, Second Edition.
3801 WEST TEMPLE AVENUE, POMONA, CA 91768
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should be on letterhead, typed in English, dated, signed, and otherwise legible. It is not appropriate for professionals
to evaluate members of their family.
Documentation to Support the Diagnosis and Accommodations Must be Recent
Eligibility for accommodations and services are based upon clear evidence of the current impact of the disability on
the student's academic performance. In most cases, this means that a diagnostic evaluation has been completed
within the past 5 years. Documentation that is more than 5 years old may be considered if the previous assessment is
applicable to the current or anticipated setting. If documentation is inadequate in scope or content, or does not
address the individual's current level of functioning and need for accommodations, reevaluation may be needed.
Documentation Must Include the Following Components:
A. Evidence that Diagnostic Criteria is Met
1. Provide a specific diagnosis of ADHD, including specifiers, based on current DSM criteria. A provisional
diagnosis is not acceptable.
2. Provide historical information to support a childhood onset of symptoms. It is always helpful to
summarize historical records that establishes symptomatology indicative of ADHD across the life span
such as elementary, middle school, and/or high school report cards, Individualized Education Plans, 504
Plans, past psycho-educational testing reports, teacher comments, tutor evaluations, and disciplinary
records.
3. Describe the manner in which rule-outs were made (e.g., historical information, observation, or test
results, etc.) for possible alternative explanations for ADHD symptoms, including: malingering, substance
abuse etiology, etiological medical condition, other mental disorder.
a. Evidence regarding the diagnosis should be more than a self-report by the person being evaluated.
Checklists and/or surveys can serve to supplement the diagnostic profile but in and of themselves
are not adequate for the diagnosis of ADHD and do not substitute for clinical observations and sound
diagnostic judgment.
b. Selected subtest scores from measures of intellectual ability, memory function tests, attention or
tracking tests, or continuous performance tests do not, by themselves, establish the presence or
absence of ADHD.
c.
A positive response to medication by itself does not constitute a diagnosis.
B. Evidence of Current Impairment
1. Reconfirm the diagnosis with supportive clinical data and updated rationale for accommodations. It is
not sufficient for documentation to simply refer to a prior diagnosis as confirmatory evidence of ADHD.
2. Describe the individual’s current ADHD symptoms as they present in two or more settings. Since ADHD
tends to affect people across situations in multiple life domains, it is necessary to show that the
impairment is not confined to only the academic setting or to only one circumscribed area of functioning.
3. Address the current severity and frequency of symptoms and how these substantially limits learning.
The qualified professional should specifically describe to what degree the disorder presently affects the
individual in the academic context for which the student is requesting accommodations.
4. Neuropsychological or psychoeducational assessment is important in determining the current impact
of the disorder on an individual's ability to function academically, such as test-taking settings. Such
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assessments might include testing of intellectual functioning, academic achievement, processing speed,
fluency, executive functioning, language, memory and learning, attention, etc. A complete
psychoeducational or neuropsychological assessment is the primary tool for determining the degree to
which the ADHD currently impacts the individual relative to taking standardized tests.
a. The reporting of test scores must be complete, not selective. If grade equivalents are reported, they
must be accompanied by standard scores and/or percentiles. All data must logically reflect a
substantial limitation to learning for which the individual is requesting the accommodation.
b. If a formal psychological assessment is done to help document the presence of functional
limitations, it is important that the student undergo such testing while taking his/her prescribed
psychotropic medication. Although the ADAAA prevents considering a therapeutic response to
medication to deny the presence of a disabling condition, taking into account the impact of the
treatment regimen is relevant to the granting of appropriate accommodations.
c.
Evaluators should describe whether or not the individual was taking psychotropic medication at the
time of the evaluation, and indicate the extent to which any and all of the treatment provides a
positive response and/or negative side effects. The use of medication in and of itself either support
or negate the need for accommodation(s).
Documentation Must Provide Rationale for Each Requested Accommodation
Accommodation requests need to be tied to evidence of current functional impairment that supports their use. A
diagnosis by itself does not automatically warrant accommodations. An explanation must be provided as to why each
accommodation is recommended and should correlate specifically to functional limitations identified through the
evaluation process.
1.
“Test anxiety” is not a sufficient diagnosis and would not support a request for testing accommodations.
Given that many individuals may believe that they would benefit from extended time in testing situations,
evaluators must provide specific rationales and justifications for the recommended accommodation.
2. A prior history of accommodations, without demonstration of current need, does not in itself warrant the
provision of similar accommodations. Records of prior accommodations and/or auxiliary aids – including
information about specific conditions under which the accommodations were used (e.g., standardized
testing, final exams, licensing or certification examinations, etc.) and whether or not they benefited the
individual – are useful in establishing an appropriate accommodation history; however, documentation must
also validate the need for services based on the individual's current level of functioning in an educational
setting. A school plan such as an Individualized Education Program (IEP) or 504 Plan is insufficient
documentation by itself but can be included with a more comprehensive evaluative report.
3. If no prior accommodations were provided, the qualified professional and/or the individual requesting
accommodations must include an explanation of why accommodations are needed at this time.
4. Psychoeducational or neuropsychological testing is often necessary to support the need for specific
academic accommodations due to the impact of ADHD on specific areas of processing deficit. Providing
standardized measures of performance on a range of academically relevant tasks can guide the
accommodation-granting process by objectively demonstrating the need for specific accommodations (e.g.,
extra time on tests due to deficits in information processing speed, computer-assisted reading software due
to phonological core deficits, etc.).
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APPENDIX: Assessing Adolescents and Adults with ADHD2
The diagnosis of ADHD is strongly dependent on a clinical interview in conjunction with a variety of formal and
informal measures. Since there is no one test, or specified combination of tests, for determining ADHD, the diagnosis
of Attention Deficit/Hyperactivity Disorder requires a multifaceted approach. Any tests that are selected by the
evaluator should be technically accurate, reliable, valid, and standardized on the appropriate norm group. The most
recent version of the test should always be used unless the evaluator can offer a rationale for use of an older version.
The following list includes a variety of measures for diagnosing ADHD and/or LD/ADHD. It is meant to be a helpful
resource to evaluators but not a definitive or exhaustive listing.
The Clinical Interview
The evaluator should: 1) Provide retrospective confirmation of ADHD; 2) Establish relevant developmental and
academic markers; 3) Determine any other co-existing disorders; and 4) Rule out other problems that may mimic
ADHD symptoms.
Specific areas to be addressed include:
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Family history
Medical history, including serious illnesses, hospitalizations, brain injuries with/without loss of consciousness
Presence of ADHD symptoms since childhood or early adolescence
Presence of ADHD symptoms in the last six months
Evidence that symptoms cause a significant impairment over time
Qualitative information on the extent of current functional impairment (e.g., academic, occupational, social)
Results of clinical observation for hyperactive behavior, impulsive speech, distractibility
Presence of other psychiatric conditions (mood or anxiety disorders, substance abuse, etc.)
Indication that symptoms are not due to other conditions (e.g., depression, drug use, medical conditions)
Relevant medication history and response to treatment
Periods during which the student was symptom-free and/or did not require accommodation
Accommodations that have minimized the impact of functional limitations in the past or present setting
Remediation approaches and/or compensating strategies that are currently effective or ineffective
Rating Scales
Self-rated or interviewer-rated scales for categorizing and quantifying the nature of the impairment may be useful in
conjunction with other data. Selected examples include:
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Achenbach System for Empirically Based Assessment (ASEBA)
ADD-H Comprehensive Teachers Rating Scale (ACTeRS)
ADDES-Secondary Age
ADHD Rating Scale-IV
ADHD Symptom Checklist–4 (ADHD-SC4)
Attention-Deficit Disorders Evaluation Scale: Secondary-Age Student (ADDES-S)
Beck Anxiety Inventory (BAI)
Beck Depression Inventory (BDI-II)
2
Source: Office of Disability Policy, Educational Testing Service (2008). Policy Statement for Documentation of AttentionDeficit/Hyperactivity Disorder (ADHD) in Adolescents and Adults, Second Edition, p. 17-20.
http://www.ets.org/disabilities/documentation/documenting_adhd/#appendixc
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Behavior Assessment System for Children-2 (BASC-2)
Behavior Rating Inventory of Executive Functioning (child or adult version)
Brown Attention-Deficit Disorders Scale
Conners' Parent Rating Scale (age 3–17 years)
Conners' Teacher Rating Scale (age 3–17 years)
Conners' Rating Scales-3 (Conners 3)
Conners' Adult ADHD Rating Scales (CAARS)
Conners' Comprehensive Behavior Rating Scales (Conners CBRS)
Copeland Symptom Checklist for Adult Attention-Deficit Disorders (CSCAADD)
Hamilton's Depression Rating Scale
Wender Utah Rating Scale (WURS) and Parent's Rating Scale (PRS)
Observational Forms
These are primarily for children and teenagers in the classroom setting. Selected examples include:
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ADHD School Observation Code
ADHD Direct Observation System
BASC-2 Student Observation System
CBC/Test Observation Form
Child Behavior Checklist/Direct Observation Form
School Hybrid Observation Code for Kids
Neuropsychological and Psycho-Educational Testing
Cognitive and achievement profiles may suggest attention or information-processing deficits. No single test or subtest
should be used as the sole basis for a diagnostic decision. Selected examples include:
Tests of Intellectual Functioning
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Kaufman Adolescent and Adult Intelligence Test
Reynolds Intellectual Assessment Scales (RIAS)
Stanford-Binet 5 (SB5)
Wechsler Adult Intelligence Scale – IV (WAIS-IV)
Woodcock-Johnson III – Tests of Cognitive Ability
Attention, Memory, and Learning
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Attention Capacity Test (ACT)
Brown Attention-Deficit Disorder Scale
California Verbal Learning Test-Second Edition (CVLT-II)
Conners' Continuous Performance Test (CPT)
Detroit Test of Learning Aptitude – 4 (DTLA-4)
Detroit Test of Learning Aptitude-Adult (DTLA-A)
Gordon Diagnostic Systems (GDS)
Integrated Visual and Auditory Continuous Performance Test (IVA+Plus)
 Kagan Matching Familiar Figure Test (KMFFT)
 Paced Auditory Serial Test (PASAT)
 Test of Everyday Attention for Children (TEA-Ch)
 Tests of Variable Attention Computer Program (TOVA)
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WAIS-IV Working Memory Index
Wechsler Memory Scales – III (WMS-III)
Executive Functioning
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BRIEF
Delis-Kaplan Executive Function System
Stroop Color and Word Test
Trail Making Test Parts A and B
Tower of London-Second Edition
Wisconsin Card Sorting Test (WCST)
Academic Achievement
Specific achievement tests are useful instruments when administered under standardized conditions and
when the results are interpreted within the context of other diagnostic information. NOTE: The Wide Range
Achievement Test (WRAT) or the Nelson-Denny Reading Test is not comprehensive measure of achievement
and should not be used as the sole measure of achievement.
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Scholastic Abilities Test for Adults (SATA)
Stanford Test of Academic Skills (TASK)
Wechsler Individual Achievement Test – III (WIAT-III)
Woodcock-Johnson Psychoeducational Battery – III: Tests of Achievement
Supplemental Achievement Tests:
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Gray Oral Reading Test (GORT 4th Ed)
Nelson-Denny Reading Test (with standard and extended time)
Stanford Diagnostic Mathematics Test
Test of Written Language – 3 (TOWL-3)
Woodcock Reading Mastery Tests – Revised
Medical Evaluation
Medical disorders may cause symptoms resembling ADHD. Therefore, it may be important to rule out the following:
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Neuroendocrine disorders (e.g., thyroid dysfunction)
Neurologic disorders
Impact of medication on attention if tried, and under what circumstances
Sleep disorders
Collateral information
Include third-party sources that can be helpful to determine the presence or absence of ADHD in childhood:
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Description of current symptoms (e.g., by spouse, teachers, employer)
Description of childhood symptoms (e.g., parent)
Information from old school and report cards and transcripts
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